Hypoxia, Pulmonary Infection, Pulmonary Nodule
Conditions
Keywords
fiberoptic bronchoscopy, Hypoxia, Deep sedation, supine position, tongue-base fallback, supraglottic oxygenation
Brief summary
Bronchoscopy is now widely used for the diagnosis and treatment of various respiratory diseases. However, the procedure is highly stimulating and provokes a strong stress response; because the airway is shared, patients are prone to hypoxia. With the growing emphasis on comfortable care, demand for anesthesia during bronchoscopy has increased. Deep sedation is the most common approach, but when administered in the supine position it often causes the tongue base to fall back. Both nasopharyngeal and oropharyngeal airways can relieve this obstruction, yet neither connects seamlessly to an oxygen supply line, resulting in insufficient oxygen delivery.We therefore replaced the nasopharyngeal airway with a wired endotracheal tube (size 4.0 or 4.5) inserted via the nose. This thinner tube couples easily to an oxygen line or ventilator circuit, partially relieves airway obstruction, and allows ample supraglottic oxygenation. The present study was designed to evaluate the feasibility and safety of this modified oxygen-delivery method in patients undergoing deep sedation for bronchoscopy.
Interventions
DEVICEwire-reinforced tracheal tube
Supraglottic oxygen therapy delivered via wire-reinforced nasotracheal tube
Sponsors
First Affiliated Hospital of Zhejiang University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Undergoing fiberoptic bronchoscopy under deep sedation. * Written informed consent obtained from the patient or their legal representative. * Clear understanding of, and voluntary participation in, the study, with informed-consent form signed by the patient or their legal representative.
Exclusion criteria
* Age \< 18 years * BMI \> 30 kg/m² * Previous history of abnormal recovery from anesthesia/surgery * History of recurrent epistaxis, nasal bone fracture, nasal polyps, or sinus surgery * Chronic use of opioid analgesics, benzodiazepine hypnotics, or antidepressant medications * Known allergy to any of the anesthetic agents employed * Anticipated difficult airway * Increased intracranial pressure * Active upper-respiratory-tract infection of the oral, nasal, or pharyngeal regions * Severe cardiac insufficiency (functional capacity \< 4 METs) * Severe renal failure requiring dialysis prior to surgery * Pre-operative oxygen saturation on room air \< 92 % * Any condition that, in the opinion of the investigator, renders the patient unsuitable for participation in this trial
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The incidence of hypoxia（75% ≤ SpO2 < 90% for <60 s） | Periprocedural |
Secondary
| Measure | Time frame |
|---|---|
| The incidence of sub-clinical respiratory depression(90% ≤ SpO2 < 95%) | Periprocedural |
| The incidence of severe hypoxia(SpO2 < 75% or 75% ≤ SpO2 < 90% for ≥60 s) | Periprocedural |
Countries
China
Contacts
CONTACTYueying Zheng
CONTACTYeke Zhu
Outcome results
None listed